Skip to main content
Log in

Sequential occurrence of IgA nephropathy and Henoch-Schönlein purpura: support for common pathogenesis

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

We report a patient who developed Henoch-Schönlein purpura (HSP) 13 years after he presented with IgA nephropathy (IgAN). In both HSP and IgAN renal biopsy most commonly reveals focal proliferative glomerulonephritis on light microscopy and immunofluorescence displays mesangial IgA deposits. In addition, patients with HSP or IgAN have elevated serum IgA levels, circulating IgA immune complexes, IgA-bearing lymphocytes, immunoglobulin-producing cells, and binding of IgG to glomerular components of similar molecular weight. The occurrence of both diseases in the same patient or the same families and the presence of immune abnormalities compatible with HSP or IgAN in relatives of patients with these diseases suggest a common pathogenesis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Henoch EH (1874) Veber eine eigenthumliche Form von Purpura. Berl Klin Wochenschr 11:641–643

    Google Scholar 

  2. Meadow SR (1972) Schönlein-Henoch purpura. Q J Med 163:241–258

    Google Scholar 

  3. Meadow SR (1992) Schönlein-Henoch purpura. In: Edelman CM Jr (ed) Pediatric kidney disease, 2nd edn. Little, Brown and Company, Burton/Toronto/London, pp 1525–1533

    Google Scholar 

  4. Koskimies O, Mir S, Rapola J, Vilksa J (1981) Henoch-Schönlein nephritis: long term prognosis of unselected patients. Arch Dis Child 56:482–484

    Google Scholar 

  5. Michalk D, Waldherr E, Seelig HP, Weber HP, Schoren K (1980) Idiopathic mesangial-IgA glomerulonephritis in childhood. Eur J Pediatr 134: 13–22

    Google Scholar 

  6. Southwest Pediatric Nephrology Study Group (1982) A multicenter study of IgA nephropathy in children. Kidney Int 22:643–652

    Google Scholar 

  7. Cream J (1970) Schönlein-Henoch purpura in the adult. Q J Med 156: 461–484

    Google Scholar 

  8. Nakomoto Y, Asano Y, Dohi K, Fujioka M, Iida H, Kida H, Kibe Y, Haltori N, Takeuchi J (1978) Primary IgA glomerulonephritis and Schönlein-Henoch purpura: clinicopathological and immunohistological characteristics. Q J Med 188:495–516

    Google Scholar 

  9. Coppo R, Basolo B, Martina G, Rollino C, DeMarchi M, Gracchino F, Mazzucco G, Messina M, Piccoli G (1981) Circulating immune complexes containing IgA, IgG and IgM in patients with primary IgA nephropathy and Henoch-Schönlein nephritis. Correlation with clinical and histological signs of activity. Clin Nephrol 18:230–239

    Google Scholar 

  10. Trygstad CW, Stiehm ER (1971) Elevated serum IgA globulin in anaphylactoid purpura. Pediatrics 47:1023–1028

    Google Scholar 

  11. Kuno-Sakai H, Sakai H, Nomoto Y, Takakura I, Kimura M (1979) Increase of IgA-bearing lymphocytes in children with Henoch-Schönlein purpura. Pediatrics 64:918–922

    Google Scholar 

  12. Casanueva B, Rodriguez-Valverde V, Merino J, Arias M, Garcia-Fuentes M (1983) Increased IgA-producing cells in the blood of patients with active Henoch-Schönlein purpura. Arthris Rheum 26:854–860

    Google Scholar 

  13. Nomoto Y, Sakai H, Arimori S (1979) Increase of IgA-bearing lymphocytes in peripheral blood from patients with IgA nephropathy. Am J Clin Pathol 79:158–160

    Google Scholar 

  14. Casanueva B, Rodriguez-Valverde V, Arias M, Vallo A, Garcia-Fuentes M, Rodriguez-Soriano J (1986) Immunoglobulin-producing cells in IgA nephropathy. Nephron 43:33–37

    Google Scholar 

  15. Jen-Jar Lin, Stewart CL, Kaskel FJ, Fine R (1993) IgG and IgA classes of anti-neutrophil cytoplasmic autoantibodies in a 13-year-old girl with recurrent Henoch-Schönlein purpura. Pediatr Nephrol 7:143–146

    Google Scholar 

  16. O'Donoghue DJ, Jewkes F, Prosthelwaite RJ, Ballardie FW (1992) Autoimmunity to glomerular antigens in Henoch-Schönlein nephritis. Clin Sci 83:281–287

    Google Scholar 

  17. Ballardie FW, Brenchley PEC, Williams S, O'Donoghue DJ (1988) Autoimmunity in IgA nephropathy. Lancet II:588–592

    Google Scholar 

  18. Wall Bake AWL van den, Daha MR, Woude FJ van de, Halma C, Schrama E, Es LA van (1989) IgA class anti-neutrophil cytoplasmic antibodies (IgA ANCA) in primary IgA nephropathy. APMIS [Suppl] 6:25–26

    Google Scholar 

  19. Meadow SR, Scott DG (1985) Berger disease: Henoch-Schönlein syndrome without the rash. J Pediatr 106:27–32

    Google Scholar 

  20. Miyagawa S, Dohi K, Hanatani M, Yamanaka F, Okuchi T, Sakamoto K, Isjikawa H (1989) Anaphylactoid purpura and familial IgA nephropathy. Am J Med 86:340–342

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Silverstein, D.M., Greifer, I., Folkert, V. et al. Sequential occurrence of IgA nephropathy and Henoch-Schönlein purpura: support for common pathogenesis. Pediatr Nephrol 8, 752–753 (1994). https://doi.org/10.1007/BF00869111

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00869111

Key words

Navigation